Fibro Fixes
Sometimes the key to finding relief from the pain, fatigue and other symptoms of fibromyalgia is going through the trial and error of existing treatments and therapies until an effective combination of treatments is found. Here are several options worth trying:
Medications
Currently, there is only one FDA-approved drug for fibromyalgia: pregabalin (Lyrica). Lyrica was originally developed as an anti-seizure medication, but has since shown benefits in relieving anxiety, some sleep problems and pain in people with fibromyalgia. Another anti-seizure medication, gabapentin (Neurontin) is sometimes used off-label (meaning it is used for but not FDA-approved for a condition) for fibromyalgia.
Four other types of medications have also been shown to provide symptom relief. Doctors can and do prescribe these medications to fibromyalgia patients, sometimes at doses specific for treating fibromyalgia symptoms. They include:
• Analgesics, including tramadol (Ultracet, Ultram)
• Antidepressant medications, such as amitryptiline hydrochloride (Elavil, Endep), duloxetine (Cymbalta), fluoxetine (Prozac) and paroxetine (Paxil)
• Muscle relaxants, such as cylobenzaprine (Cycloflex, Flexeril)
• Fatigue medications, such as modafinil (Provigil)
Other medications are being investigated for their usefulness in people with fibromyalgia, as well.
Exercise
Physical activity is one thing that consistently improves symptoms of fibromyalgia, but the right activities must be started at a low level and increases must be introduced slowly.
“Deconditioned muscles are a potent pain generator in fibromyalgia,” says Kim Jones, PhD, a fibromyalgia researcher at
“The trick is to exercise slowly enough that you can condition muscle without generating pain, and we’re finding perhaps this can be done more efficiently if people with fibromyalgia are given the drug pyridostigmine (Mestinon) prior to exercise,” she says.
Jones and colleagues discovered that most people with fibromyalgia do not secrete sufficient growth hormone when exercising vigorously. Growth hormone helps build muscle tissue, so not having an adequate supply may contribute to exercise-induced muscle pain in people with fibromyalgia. Pyridostigmine blocks a hormone called somatostatin, which inhibits the production of growth hormone. The drug is FDA-approved to treat myasthenia gravis, an autoimmune disorder in which control of muscles is gradually lost. Jones’ study suggests the drug can normalize growth hormone levels in fibromyalgia patients during exercise so that they can better tolerate physical activity, but the drug is used only experimentally in this way.
Jones also says a product called Spray and Stretch, a spray-on skin refrigerant or topical anesthetic that numbs pain, can be helpful when people with fibromyalgia have too much pain when they first start an exercise program. “Using a skin refrigerant before stretching can help make the workout session less painful, reducing the chance that the patient will stop trying to exercise and allowing them to get the benefits of being physically active,” says Jones.
Next: Biofeedback, Stress Reduction and Lifestyle Adaptation
